NPIMap

Organization Active NPI

Pyramid Healthcare Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Erie, PA
National Provider Identifier
1063533040
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
257077 Issued in PA
Legal business name
PYRAMID HEALTHCARE INC.
Practice address
1325 W 26TH St
Erie, PA 16508-1469
Phone
(814) 456-2203
NPI assigned
Apr 3, 2007
Last updated
Apr 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jason Hendricks
Title
Ceo
Phone
(814) 940-0407

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 257077 PA Primary

Addresses

Primary practice location

1325 W 26TH St
Erie, PA 16508-1469

Mailing address

PO Box 967
Duncansville, PA 16635-0967
Phone (814) 940-0407

Other practice location 1

2409 State St
Erie, PA 16503-1856
Phone (814) 456-2203

Other identifiers 7

IdentifierTypeStateIssuer
1007625050097MedicaidPA
1007625050094MedicaidPA
1007625050096MedicaidPA
1007625050154MedicaidPA
1007625050153MedicaidPA
1007625050155MedicaidPA
257077OtherPALICENSE NUMBER

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2241601Pyramid Healthcare Erie Outpatient2409 State Street, 1St Floor Suite C, Erie, PA 16503Certificate of waiverOct 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Pyramid Healthcare40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1063533040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 967",
            "city": "DUNCANSVILLE",
            "state": "PA",
            "postal_code": "166350967",
            "telephone_number": "814-940-0407",
            "fax_number": "814-941-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081469",
            "telephone_number": "814-456-2203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2409 State St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165031856",
            "country_code": "US",
            "telephone_number": "814-456-2203",
            "fax_number": "814-456-2205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PYRAMID HEALTHCARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-940-0407",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "PA",
            "license": "257077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007625050097",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007625050094",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007625050096",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007625050154",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007625050153",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007625050155",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "257077",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.